APPOINTMENT DATE: Sep 04, 2023 (11:00 AM TO 12:00 PM) - PRC XII - Koronadal Regional Office

REFERENCE NO: INLOVN2R8QPB | OR: E2023-09-06055359 (09/01/2023) | AMOUNT: PHP 1050.00

NOT FOR SALE (REPRODUCTION IS ALLOWED)

Republic of the Philippines

Professional Regulation Commission
Manila Paste here
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PANUNUMPA NG PROPESYONAL with complete
name tag

KIMBERLY ELNAR GEPULLANO

Ako, si ______________________________________________________________________, ng
_____________________________________________________________________________________
KORONADAL, SOUTH COTABATO
(Pook na Sinilangan, Bayan/Lungsod, Probinsya)
ay taimtim na nanunumpa na itataguyod ko at ipagtatanggol ang Saligang Batas ng Pilipinas, na ako ay
tunay na mananalig at tatalima rito; na susundin ko ang mga batas, mga utos na legal, at mga atas na
ipinahayag ng mga sadyang itinakdang may kapangyarihan ng Republika ng Pilipinas; at kusa kong
babalikatin ang pananagutang ito, na walang ano mang pasubali o hangaring umiwas.

Taimtim pa rin akong manunumpa na sa lahat ng panahon at pook na kinaroroonan ay mahigpit

akong manghahawakan sa mga etikal at tuntuning propesyonal ng mga
PROFESSIONAL TEACHER
____________________________ sa Pilipinas, at marapat kong gagampanan ng buong husay sa abot ng
(Propesyon)
aking makakaya ang mga tungkulin at pananagutang iniatang sa isang itinakdang
PROFESSIONAL TEACHER
________________________.
(Propesyon)

Kasihan Nawa ako ng Diyos.

______________________________________
( Lagda)
UMID-CRN-0111-7530290-4
A - ____________________________ KORONADAL CITY
_______________________ Nov 08, 2019
_________________________
(Blg. Ng Sedula) (Kinuha sa) (Petsa)

Nilagdaan at Pinanumpaan sa harap ko ngayong ika-____________ ng ________________________

taon ng ating Panginoon _____________________ sa ___________________________, Pilipinas.

FOR PRC PROCESSING

1050.00
OK to Pay: __________________________________ __________________________________
Selyo E2023-09-06055359
OR No.: _____________________________________ (Pinunong Tagapanumpa)
Dokumentaryo Sep 01, 2023
Date Paid: ___________________________________
PROFESSIONAL TEACHER
Profession: __________________________________ __________________________________
Registration No.: ______________________________ (Katungkulang Opisyal)
Registration Date: _____________________________

PERSONAL DATA
Telephone/Contact Number: 09631818363 Date of Examination: Mar 01, 2023
Citizenship: FILIPINO Date of Birth: May 12, 1995
Civil Status: MARRIED Sex: FEMALE Spouse’s Name/Citizenship: ALIMAR GEPULLANO / FILIPINO
Father’s Name/Citizenship: EDGARDO ELNAR / FILIPINO Mother’s Name/Citizenship: ROSE ELNAR / FILIPINO

PLEASE FILL OUT THIS CLAIM SLIP

CLAIM SLIP

KIMBERLY ELNAR GEPULLANO

NAME: _______________________________________ PROFESSIONAL TEACHER
PROFESSION: _________________________________
REGISTRATION NO. ____________________________ REGISTRATION DATE: __________________________
Please present this slip at Issuance Window ____________________ to claim your professional identification card on
________________________.
(NOTE: REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULD PRESENT SPECIAL POWER OF ATTORNEY/ AUTHORIZATION
LETTER FROM THE REGISTERED PROFESSIONAL). FOR CONFIRMATION PLEASE CALL UP (02) 736-22-48.

____________________________________________
(Registration Officer)

REG- 01
Rev. 00
February 25, 2015
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